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Author:

Rory Watson

Migration

The challenges faced by countries with insufficient numbers of
trained personnel due to the phenomenon of medical migration was one of the
main themes to emerge from the conference on the future of the health sector
organised by the European Federation of Public Service Employees (Eurofedop) in
Brussels in early March.

“Of course, this is a problem. We do not see it with just one
country, but also with a lot of new and old member states,” explains Bert Van
Caelenberg, Eurofedop’s secretary general.

The Federation has recently completed a study examining best
practices in five European cities – Bucharest, Bratislava, Madrid, Paris and
London – to see how the authorities can attract and retain healthcare staff in
large cities. One scheme which may attract wider interest is the initiative in
the UK to help provide nurses with affordable accommodation.

“What we have found is that many medical professionals in central
and eastern Europe will leave as soon a possible. This is not simply due to
money. Other factors count as well, such as if politicians blame the sector for
shortcomings,” says Van Caelenberg.

A detailed presentation to the conference of the challenges facing
policy makers from the brain drain of trained medical staff came from Miklos
Szocska, the director of the management training centre at Semmelweiss
university in Budapest. He contrasted the drivers which lead doctors and nurses
to leave their home country with those that convince them to stay.

In the first category come financial incentives such as better
pay, living and working conditions and quality of life; professional
development and opportunities; public respect for the profession; and
proficiency in the relevant foreign languages. The second contains more personal
criteria: love for one’s home coun - try, family and friends; and a feeling of responsibility
for Hungarian patients and the country’s healthcare system.

He pointed out that there was a migration intention level of 70%
among medi - cal personnel in the country. This phenomenon is already leading
to noticeable shortages of specialists in key areas. These reach just under 13%
for radiology, over 10% for psychiatry and 7.4% for surgery.

As Marcela Gatciova, the president of the Slovakian organisation
SLOVES, told the 100 or so participants, the phenomenon is spreading: “The lack
of health professionals causes major problems for patients in Slovakia. A woman
I know was diagnosed with breast cancer and faced exceptionally long waiting
lists. Once under treatment, the process was very slow. This shows that even in
the case of life-threatening diseases there is simply not enough personnel
available.”

Mr Szocska, who is currently conducting a study into medical
migration, suggested policies which national authorities could implement to
slow down, if not stem, the brain drain. He pointed to the need for local
initiatives to improve career and living conditions. This should be backed by
EU-wide debates on value conflict and the promotion of ethical frameworks for
recruitment to prevent trained staff being poached.

He is also advocating that training systems take account of ways
to retain staff once they have qualified and the promotion of international
exchange schemes that emphasise the importance of retention in the long run.
Finally, he would like to see evidence used to convince decision makers to
compensate countries who receive personnel trained in other countries.

The same themes were emphasised by Anton Szalay, the chairman of
the Slovak trade union of health and social services. He began by emphasising
the need to improve salaries in a country where a physician typically earns less
than 1,150 euro a month and a nurse below 500 euro.

He underlined the need to improve working conditions and to ensure
that staff, and patients, had access to modern equipment that takes account of
the latest trends in science and technology. Eurofedop is suggesting that an EU
health platform should be established to focus on issues in the health sector
that affect its employees.

This would provide a venue where trade unions, non-governmental
organisations, politicians and regulators could examine together issues such as
patient mobility which have wide-ranging implications for all concerned.

Speaking at the conference, Austrian Christian Democrat MEP Othmar
Karas insisted that successive judgements from the European Court of Justice
(ECJ) on this sensitive issue were not sufficient against a background of
increasing patient and professional mobility.

Political prerequisites were also required, he said, calling for
“a European policy approach”.

The view is supported by the public services federation which
believes that EUwide legislation is necessary to clarify the implications of
the ECJ’s rulings on patient mobility.

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